输尿管结石患者继发输尿管息肉危险因素分析

Analysis of risk factors for ureteral polyps secondary to ureteral stone

目的:探讨输尿管结石继发输尿管息肉的危险因素。方法:回顾性分析2017年9月-2018年6月就诊于天津医科大学第二医院泌尿外科并进行手术治疗的278例输尿管结石患者的临床资料,探讨输尿管结石并发输尿管息肉的危险因素。采用SPSS20.0软件进行统计学分析,性别、年龄、BMI、吸烟史、饮酒史、高血压病史、糖尿病病史、病程长短、结石长径、患侧、结石定位、患侧肾积水程度、术前是否感染、结石形态、结石表面粗糙程度以及输尿管壁厚度进行统计分析,单因素分析采取组间χ^2检验,多因素分析采用非条件Logistic回归分析法,P<0.05表示具有统计学意义。结果:278例输尿管结石患者有134(48.2%)例术中可见结石所在位置并发输尿管息肉;采用非条件Logistic回归分析,结果显示患者病程长短、患侧肾积水程度、术前感染、结石形态、结石表面以及输尿管管壁厚度是输尿管结石并发输尿管息肉的独立危险因素(OR=1.969,OR=1.513,OR=0.288,OR=2.612,OR=2.646,OR=2.455,P<0.05)。结论:病程长短、患侧肾积水程度、术前感染、结石形态、结石表面粗糙程度以及输尿管管壁厚度是输尿管结石继发输尿管息肉的独立危险因素。

Objective: To identify the risk factors for ureter polyps secondary to ureter stones by univariate and multivariate analysis. Methods: Retrospective analysis of 278 patients with ureter stone underwent lithotriptic surgery in the Second Hospital of Tianjin Medical University from September, 2017 to May, 2018. Patients with ureter polyps (n=134) were compared with patients without ureter polyps (n=144). Univariate and multivariate analysis were used to assess several potential risk factors that may affect the occurrence of ureter polyps. Results: The overall incidence of ureter polyps was 48.2%. Univariate analysis demonstrated that longer duration, severer hydronephrosis, no preoperative infection, non-spherical stones and rough surface of the stones were risk factors for ureter polyps secondary to ureter stones. Multivariate analysis also identified longer duration, severer hydronephrosis, no preoperative infection, irregular stones morphology and rough surface of the stones as independent risk factors. Conclusion: Longer duration, severer hydronephrosis, no preoperative infection, irregular stones morphology and rough surface of the stones may be independent risk factors for ureter polyps secondary to ureter stones. These findings may assist in preoperative assessment and guide the urologists in making surgical decisions to reduce surgical risks and complications.